Senior Appeals Pharmacist — PA Oversight & Outcomes
Triwill Group
Judi Health in New York, NY seeks a subject-matter expert in prior authorization and appeals to oversee operations across multiple lines of business. This role manages a team of appeals pharmacists and staff, ensuring compliance and high quality of care. The position requires a Pharm.D. or Pharm.B, an active license, and PBM experience, with strong leadership and data-driven decision capabilities. Hybrid or flexible scheduling may apply based on business needs. #J-18808-Ljbffr Triwill Group
- ...UM criteria and decision tree oversight. Review and maintain UM... ...(e.g., prior authorization (PA) and step therapy) for clinical... ...configuration for UM setup. Partner with pharmacist Formulary, UM, and analytics... ...formulary compliance to senior leadership. Other duties/...Suggested
- Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy... ...Prepare clear written clinical rationales supporting appeal outcomes. Collaborate with physicians, nurses, and medical directors...SuggestedRemote jobWork from home
- ...for Career Enhancement in Pennsylvania seeks a Senior Manager, Pricing to lead a team focused on pharmacy reimbursement appeals, service warranty processes, and state... ...process improvements, ensure timely, accurate outcomes, and mentor staff while collaborating with legal...Senior
- WellDyne is seeking a remote Prior Authorization Clinical Pharmacist to handle clinical reviews for PA programs, under the direction of the Manager, Clinical Services. This role focuses on retail clients and adherence to regulatory standards. The candidate should be licensed...SuggestedRemote job
$240k - $275k
...continued growth, SOCOTEC is seeking a Senior Principal to provide executive leadership... ...capabilities Technical Leadership & Project Oversight Serve as the senior technical... ...accountability for project quality and client outcomes. Qualifications Required...SeniorFull timeContract work- ...Tiffany & Co. is looking for a Senior Jeweler in Queens, NY. The role emphasizes advanced stone setting and jewelry repairs, working closely with CAD technicians, ensuring the highest quality standards are met. Applicants must have 10–20 years of experience in jewelry...SeniorHourly pay
- ...their families, to achieve desired patient outcomes throughout the continuum of care.... ...base pay, merit, and premium pay Staff/Senior Level The Staff or Senior Advanced Practice... ...Clearance required Physician Assistant (PA) A graduate of a physician assistant program...SeniorFull timeMonday to Friday
$146k - $343k
...Senior Channel Sales Engineer This role has been designated as 'Remote/Teleworker', which... ...to cloud, so they can turn insights into outcomes at the speed required to thrive in today'... ...Location (Remote): NYC, NJ and PA Region We are seeking a seasoned and highly...SeniorWork experience placementRemote workWork from home- CVS Health is seeking a Senior Product Manager to lead strategy, solutioning, and execution for a value stream within the DDAT G&A product team, shaping end-to-end member, provider, and business outcomes. You will drive discovery, align stakeholders, and deliver high-impact...Senior
- ...to transition to developer representation. In this role, you will engage with developers, entrepreneurs, and institutions concerning land use, zoning, and tax assessment appeals. The position offers a highly competitive salary and benefits. #J-18808-Ljbffr AlevistarjobsSenior
- ...product managers on modern practices. This role requires strategic thinking to evolve product teams and align them with business outcomes. The ideal candidate will have a strong understanding of product operating models and experience coaching in enterprise environments...SeniorContract work
$156.5k - $230k
...level, to deliver significant business outcomes. Key responsibilities include continuously... ...and its clients.We are looking for a Senior Principal Engineer to lead and execute our... ...development approachesLeads the technical oversight for teams in solution development...SeniorFull timeWork at officeFlexible hoursDay shift- ...G Analyst to support the A&G Department in New York, NY. The A&G Analyst will be responsible for preparing and submitting External Appeals and QIO case files, ensuring compliance with State and Federal Regulatory Requirements. Qualified candidates will have a BA/BS degree...SeniorWork at office
- ...Denver, Charlotte or NYC. You will drive staffing, workflows, and quality in a fast-paced startup environment. The role requires Medicare PA experience, leadership, and strong communication. You will collaborate with clinical partners, ensure HIPAA compliance, and...SeniorLocal area
$155.97k - $176.65k
...consistently achieves the best patient outcomes through a rigorous focus on quality that... ...exciting opportunity to join our team as a Pharmacist. In this role, the successful... ...and NYS Pharmacy Laws. Provide direct oversight of pharmacy Technician maintaining NYU...Night shiftAfternoon shift$60 - $76 per hour
...District Support Pharmacist We're building a world of health around every individual —... ...accountable for supporting the management, oversight, and operation of the pharmacy and... ...to care and helping to improve patient outcomes through pharmacist delivered clinical care...Hourly payFull timeWork experience placementFlexible hoursShift workNight shift$60 - $76 per hour
...heart every day. Our District Support Pharmacists (DSPs) play a critical role in cultivating... ...for supporting the management, oversight, and operation of the pharmacy and pharmacy... ...to care and helping to improve patient outcomes through pharmacist delivered clinical care...Hourly payFull timeTemporary workPart timeWork experience placementLocal areaFlexible hoursShift workNight shift$60 - $76 per hour
...to life with heart every day. Our Staff Pharmacists play a critical role in cultivating a... ...accountable for supporting the management, oversight, and operation of all aspects within... ...to care and helping to improve patient outcomes through pharmacist delivered clinical care...Hourly payFull timeTemporary workWork experience placementLocal areaFlexible hoursShift workNight shift$60 - $76 per hour
...District Support Pharmacist We're building a world of health around every individual —... ...accountable for supporting the management, oversight, and operation of the pharmacy and... ...to care and helping to improve patient outcomes through pharmacist delivered clinical care...Hourly payFull timePart timeWork experience placementFlexible hoursShift workNight shift$80 per hour
...consistently achieves the best patient outcomes through a rigorous focus on quality that... ...opportunity to join our team as a Per diem Pharmacist. In this role, the successful... ...policies and Federal Law. Provide direct oversight of pharmacy Technician maintaining NYULMC...Hourly payDaily paid$96.22k - $120.29k
...connected care services that provide better outcomes at a reduced total cost of care.... ...Description Position Summary: The Oncology Pharmacist will provide oncology pharmaceutical... ...to maintain high productivity through oversight of pharmacy technician(s). Establishes...Work at officeLocal area$80 per hour
...consistently achieves the best patient outcomes through a rigorous focus on quality that... ...opportunity to join our team as a Per diem Pharmacist. In this role, the successful candidate... ...policies and Federal Law.Provide direct oversight of pharmacy Technician maintaining...Hourly payDaily paid$60 - $70 per hour
...recruiting several clinical Pharmacists to support a leading national... ...drug authorizations and appeals . This fully remote opportunity... ...team dedicated to patient outcomes and quality care. Primary... ...interviews: ~30 minutes with a Senior Clinical Pharmacist ~30...Contract workTemporary workRemote workFlexible hoursShift workWeekend work$66.58 - $73.24 per hour
...provide vital patient care, including assessing patients and assisting with deliveries and admissions. The ideal applicant must hold a NYS PA license and NCCPA certification, along with BLS, ACLS, and PALS certifications. NICU experience and computer knowledge are also...SeniorHourly payDaily paid$60 - $76 per hour
...heart every day. Our District Support Pharmacists (DSPs) play a critical role in cultivating... ...for supporting the management, oversight, and operation of the pharmacy and pharmacy... ...to care and helping to improve patient outcomes through pharmacist delivered clinical care...Hourly payFull timePart timeWork experience placementLocal areaFlexible hoursShift workNight shift- Equitable Investment Management Group seeks a Senior Portfolio Analyst to join the Portfolio Analytics team. The role supports investment manager oversight, portfolio analytics, and Board-level reporting for over $120B in multi-asset portfolios across variable insurance...Senior
- Property Meld is seeking a Senior Product Manager to own outcomes for a meaningful part of our Intelligent Maintenance platform. You will be accountable for solving problems that create real value for customers and the business, not just shipping features. This role emphasizes...SeniorRemote job
- CVS Health in the United States is seeking a Senior Manager, Pricing to lead a team of professionals and contractors in managing pharmacy reimbursement appeals, including the Service Warranty process, and to support state insurance regulators and secondary appeals operations...SeniorFor contractors
- ...relationship within a collaborative care environment. The position requires an active and unrestricted license as a Nurse Practitioner, PA, or Physician, with state licensure in good standing. Minimum 6 months in long-term care is preferred. #J-18808-Ljbffr The MedElite...SeniorFull time
- ...for both the insured and the Company! As a Senior Trial Attorney, you'll handle bodily... ...Pittsburgh area, as well as Western and Central PA. Benefits and Opportunities Exceptional... ...risks effectively and drive positive outcomes that directly impact Allstate's bottom line...SeniorContract workWork at officeRemote workWork from homeWork visa
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